Predictors of the benefits women consider necessary to make adjuvant chemotherapy (ACT) worthwhile for early breast cancer (EBC)

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787 Background: ACT for EBC improves survival but is inconvenient and has side effects. Past studies of preferences show that many women who have had ACT for EBC consider small benefits sufficient to make it worthwhile (Lancet Oncol 2001; 2: 691). We sought predictors of these preferences. Methods: 118 consecutive consenting women who completed ACT 3 to 34 months previously (mean 18) were presented 4 hypothetical scenarios based on known survival times (5 and 15 yrs) and rates (65% and 85% at 5 yrs) with and without ACT. All women provided data on demographics, disease, treatment and side effects of ACT. A representative subset of 83 women also completed validated scales assessing anxiety, depression, optimism, perceived cause and impact of breast cancer. Associations were assessed with linear regression after normal score transformation of preferences. Results: Median age was 55 (range 24 to 69), 68% had a current partner, 45% had tertiary education, 68% were employed, 79% had children, 54% had dependants, and 10% lived alone. Most had AC (54%) or AC+CMF (27%). Improvements of 1% in 5 year survival rates or 3 months extra life expectancy were considered sufficient to make ACT worthwhile by most women (62% to 65%). Factors associated with these preferences (and not) are summarised in the Table. Conclusions: Preferences were highly variable, but many women considered small benefits sufficient to make ACT worthwhile. Circumstances and experiences were stronger predictors of preferences than psychological factors. These issues should be considered when discussing ACT with women. No significant financial relationships to disclose.